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津巴布韦哈拉雷地区孕期高频亲密伴侣暴力、产后抑郁及自杀倾向

High-frequency intimate partner violence during pregnancy, postnatal depression and suicidal tendencies in Harare, Zimbabwe.

作者信息

Shamu Simukai, Zarowsky Christina, Roelens Kristien, Temmerman Marleen, Abrahams Naeemah

机构信息

Gender and Health Research Unit, Medical Research Council, 7505 Tygerberg, South Africa; School of Public Health, University of the Western Cape, 7535 Bellville, South Africa; Foundation for Professional Development, 0184 Pretoria, South Africa.

School of Public Health, University of the Western Cape, 7535 Bellville, South Africa; University of Montreal Hospital Research Centre, Montreal, QC, Canada H2X 0A9.

出版信息

Gen Hosp Psychiatry. 2016 Jan-Feb;38:109-14. doi: 10.1016/j.genhosppsych.2015.10.005. Epub 2015 Oct 23.

Abstract

INTRODUCTION

Intimate partner violence (IPV) is a common form of violence experienced by pregnant women and is believed to have adverse mental health effects postnatally. This study investigated the association of postnatal depression (PND) and suicidal ideation with emotional, physical and sexual IPV experienced by women during pregnancy.

METHODS

Data were collected from 842 women interviewed postnatally in six postnatal clinics in Harare, Zimbabwe. We used the World Health Organization versions of IPV and Centre for Epidemiological Studies - Depression Scale measures to assess IPV and PND respectively. We derived a violence severity variable and combined forms of IPV variables from IPV questions. Logistic regression was used to analyse data whilst controlling for past mental health and IPV experiences.

RESULTS

One in five women [21.4% (95% CI 18.6-24.2)] met the diagnostic criteria for PND symptomatology whilst 21.6% (95% CI 18.8-24.4) reported postpartum suicide thoughts and 4% (95% CI 2.7-5.4) reported suicide attempts. Two thirds (65.4%) reported any form of IPV. Although individual forms of severe IPV were associated with PND, stronger associations were found between PND and severe emotional IPV or severe combined forms of IPV. Suicidal ideation was associated with emotional IPV. Other forms of IPV, except when combined with emotional IPV, were not individually associated with suicidal ideation.

CONCLUSION

Emotional IPV during pregnancy negatively affects women's mental health in the postnatal period. Clinicians and researchers should include it in their conceptualisation of violence and health. Further research must look at possible indirect relationships between sexual and physical IPV on mental health.

摘要

引言

亲密伴侣暴力(IPV)是孕妇经历的一种常见暴力形式,被认为会对产后心理健康产生不良影响。本研究调查了产后抑郁症(PND)和自杀意念与女性孕期经历的情感、身体和性方面的亲密伴侣暴力之间的关联。

方法

数据收集自津巴布韦哈拉雷六家产后诊所的842名产后接受访谈的女性。我们分别使用世界卫生组织版本的亲密伴侣暴力量表和流行病学研究中心抑郁量表来评估亲密伴侣暴力和产后抑郁症。我们从亲密伴侣暴力问题中得出暴力严重程度变量和亲密伴侣暴力变量的综合形式。使用逻辑回归分析数据,同时控制过去的心理健康和亲密伴侣暴力经历。

结果

五分之一的女性[21.4%(95%置信区间18.6 - 24.2)]符合产后抑郁症症状的诊断标准,而21.6%(95%置信区间18.8 - 24.4)报告有产后自杀念头,4%(95%置信区间2.7 - 5.4)报告有自杀未遂情况。三分之二(65.4%)报告有任何形式的亲密伴侣暴力。虽然个别形式的严重亲密伴侣暴力与产后抑郁症有关,但产后抑郁症与严重情感亲密伴侣暴力或亲密伴侣暴力的严重综合形式之间的关联更强。自杀意念与情感亲密伴侣暴力有关。除与情感亲密伴侣暴力结合外,其他形式的亲密伴侣暴力与自杀意念无单独关联。

结论

孕期的情感亲密伴侣暴力会对女性产后心理健康产生负面影响。临床医生和研究人员应将其纳入暴力与健康的概念范畴。进一步的研究必须探讨性和身体亲密伴侣暴力对心理健康可能存在的间接关系。

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